Assisted Living

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Assisted Living

Designing for the Assisted Living

Currently, primary care remains reactive. This means that in this system, people wait until they become sick before the care is actually provided. For the most part, the system was not designed to help prevent the onset of illness but instead to diagnose and treat it once it becomes problematic. In this research, we explore opportunities to rethink the model for care in assisted living communities using biometric technology, building upon primary research we’ve conducted in several senior homes in the Seattle area.

New biometric sensing technologies hold tremendous promise in healthcare. They bring us closer than ever to bridging the gaps in patient care by allowing us to generate real-time patient health data and to shift our global approach to care from reactive to proactive, from passive to preventative.

Research

Research

Research question:

How can biometric sensing wearables be integrated into modern healthcare systems?

Secondary Research:

Topics Surveyed

We started off by researching many health compliance topics but ultimately decided on tackling Assisted Living Facilities as our target problem space. We thought of chronic care as a smaller scale healthcare industry’s need of shift, towards proactive and predictive care solutions. With this, we were hoping to generate insights that could be scaled to the greater healthcare system.

Primary Research:

Research Goals

What is the influence of the relationship between Caregivers and Residents and the impact of the quality of care delivered as a result?

10 Participants

Group A:

Employees of assisted living communities

Involved with in-person patient care work

Worked in facility for more than a year

English speaking

Group B:

Residents of assisted living communities that were ages 65+

Have been residents for more than a year

English speaking

Merrill Gardens Participants

Activities Performed

1. Interviews or Contextual Inquiry

We gave participants a choice of a formal sit-down interview or a contextual inquiry where we follow the participant along in their activities and routines. We provided this choice with respect to each participant’s privacy and comfort levels.

2. Personal Inventory

We will ask participants to show us some of the items in their personal space in order to better understand the roles that certain material artifacts, tools, and technologies play in the participants’ daily routines.

3. Activity Observation

After interviewing our participants, we conducted purely observational studies where we watch the participant perform their daily routine without intrusion. Depending on what activities the participant has planned for their day, this could have meant observing a caretaker-resident interaction, or an independent caretaker or resident activity.

Caregiver Participant: Krissa

I like being able to talk to patients about themselves—to be able to have that moment of connection with them where it’s not just a nurse talking to a patient, but rather a person talking to a person.

You have to document literally everything…It can be very overwhelming and time-consuming.

Resident Participant: Miki

In the morning I have my routine…Some people have caregivers come in every morning to help them take their medications and get ready. I think they [the caregivers] do a really fantastic job.

I don’t always want to be here. It’s hard when you’re made to feel like you can’t be independent.

Analyze & Synthesize

Codes

1. Grouping Codes

First, we gathered all of our data, pulling quotes and notes from our research. We stuck them on a whiteboard that generally grouped together. These notes were called codes.

Themes

2. Categorizing Themes

Next, these codes were further categorized into specific topics, pain points, or opportunities and were given blue sticky notes on the side to show their similar themes.

Insights

3. Generating Insights

Lastly, from our categorized themes, we were able to generate insights on our problem space. These insights helped guide our process by making sure our solution explored and prioritized the most important design opportunities.

Insights

1. Residents want Agency in their Healthcare:

In addition tofeelings of isolation, residents often fear feeling vulnerable when facing their declining health and need for assistance. They deeply value their independence and want better control in understanding and mediating their own health.

2. Quality of Care is Interpersonal:

Caregivers often cite that 1:1 patient interactions are the most important work they do, although manual tasks such as documentation and record-keeping take up most of their time. They value the emotional connections the make with residents and see companionship as the most effective tool for improving the quality of care.

3. Assisted Living Facilities are Under-resourced:

Due to patient demands and time-intensive manual tasks, like record keeping, pre-planned agendas are rarely met and often become impulsive.

Final Solution

Final Solution

Concept Ideation

Concept Ideation

This concept explored one of the biggest pain points of communicating amongst team members. Essentially, an app would be used in tandem with a cloud storage base that would hold all of the resident's personal information, allowing the caregivers access to such information.

By allowing the caregivers online access to information, the tedious process of physically documenting would be eliminated. This information could would be backed up and processed for other team members in different vicinities or even shifts.

Design Solution

Route to Empowerment

Ecosystem Diagram

Shifting Roles:

Our solution aims to change the ecosystem of how caregivers and residents interact. Typically, a caregiver has a set schedule of Resident's to see throughout the day but can waste important resources on tedious and manual work depending on the daily requirements of each person. The biggest goal between the Caregivers and Residents is to achieve the long term goal set by the Resident. By equalizing the relationship to advising rather than care taking, the Residents are able to control their health journeys and how to get there.

More focus on Interpersonal Care:

However, by shifting the role of a Caregivers to a health consultant, the residents are able to create personalized health plans from the start, and achieve long term goals. Creating this shift allows Caregivers to focus on the interpersonal relationships that determine the actual quality of care, built on compassion and not solely medical treatment.

Providing Residents Agency:

By allowing the resident to have agency in their health, they are able to actively participate in becoming healthier through personalized routes to achieve goals set by themselves. With the help of Biometric Data Wearables, the Caregivers are able to consistently monitor basic biometrics and help guide the residents with healthier lifestyle choices. By having access to these biometrics, Caregivers can see longterm trends ranging from hours to even months to accurately advice their Residents. These can consist of suggesting certain types of exercise, diets, stress relievers, or even similar community group members partaking in the same activities to provide convenience.

Initial Solution

Caregiver UI

UI Thought Process:

In this example, June Cleary is the Resident selected on the interface for the Caregiver. The left hand side shows an online profile of each Resident with the times of its last update. The UI conveys a customizable dropdown of the Resident's conditions that were prioritized and observed. The patterns are able to be observed, seeing spikes in certain hours of the day. The benefit was to pinpoint causations of certain spikes to be able to treat.

During the daily checkups, the caregivers would take initiative to talk about how the Residents are sticking to their selected journey. If they are doing well, positive feedback is provided to keep the success going. However, if the resident starts to divert from their journey, the caregiver would suggest alternatives activities to help them back on track.

Simple & Great Feedback:

If I were paying a lot of money to live here, I wouldn’t want to see that I am only at 85% health everyday. 

Final Solution

Caregiver UI

Finding the Balance:

After some much needed feedback, we knew we had some redesigning to do. At a certain point, we had to find the right balance of helping the Resident's become healthier without discouraging them. A previous issue that we attempted to tackle was having too many focuses and activities to work on all at once. With so many areas to work on, the Resident could be overwhelmed and discouraged.

Pivot Towards User Friendlier Solution:

After much thought, we switched the harsh visual language of numbers to a more user friendlier solution, the Priority Wheel. Instead of seeing exact numbers of someone's success and failures, one would see a band that changed in length depending on the amount of focus that a Resident wanted to allocate his or her priority. Still following the the method of empowering the Residents, the bands would allow the Residents to prioritize specific concentrations that enable them to achieve their health goal, whether that is broad or specific, without detracting from their journey.

Resident Example:

June Cleary wants to live a healthier lifestyle but would like some help. She talks to her Caregiver and together create a journey to achieve this broad goal. There are many ways to live a healthier life but June specifically wants to prioritize a consistent Exercising and Diet regime. She believes her Medication, Sleep, and Mental Health are at a stable level, and so she does not need to prioritize these. Therefore, these bands becoming smaller in priority.

Resident UI

Simplified UI:

This interface is simplified purely fore the Residents. Depending on what topic the Caregiver and Resident are talking about, the UI reduces to only what the bare minimum of what the Resident needs to know. It is easy on the eyes and no packed with unnecessary information.

Resident Example:

In this example, June Cleary is being recommended healthy items on todays menu to help her Diet band that she has prioritized. She can see the selections for the day and prepare what to eat.